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首页> 外文期刊>Neurosurgical focus >Rates and determinants of ventriculostomy-related infections during a hospital transition to use of antibiotic-coated external ventricular drains
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Rates and determinants of ventriculostomy-related infections during a hospital transition to use of antibiotic-coated external ventricular drains

机译：医院过渡期间肠胃术相关感染的速率和决定因素与抗生素涂覆的外部心室排水管

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Object. The authors evaluated the rates of ventriculostomy-related infections (VRIs)after antibiotic-coated extraventricular drains (ac-EVDs) were introduced as the standardof care. Methods. A retrospective chart review was conducted of adult patients admitted to NewYork-Presbyterian Hospital neurological intensive care unit in whom an EVD was placed between February 2007 and November 2009, excluding individuals receiving EVDs due to aninfection of a primary device. Three time periods were defined depending on type of EVD in use: Period 1, conventional EVDs; Period 2, either ac-EVDs or conventional EVDs; and Period 3, ac-EVDs. Definite/probable VRIs that occurred during the 3 periods were evaluatedand established as determinants of VRIs by using a Cox proportional hazards model. Prolonged systemic antibiotics were given for the duration of EVD placement in each of the 3 periods per institutional policy. Results. Data from 141 individuals were evaluated; mean patient age was 53.8 ± 17.2 years and 54% were female. There were 2 definite and 19 probable VRIs. The incidence of definite/probable VRI (per 1000 person-catheter days) decreasedfrom Period 1 to 3 (24.5, 16.2, and 4.4 in Periods 1, 2, and 3, respectively; p < 0.0001). Patients with VRIs were more likely to be female than male (23.7% vs 3.1%, p < 0.003) and have had an EVD in place for a longer duration, although there was no significant difference among the 3 periods (7.9 ± 6.7 [Period 1], 8.1 ± 7.1 [Period 2], and 8.6 ± 5.8 [Period 3] mean days; p = 0.87, ANOVA). Analysis of effect modification in a stepwise model showed that period, age, and age and female interaction were significant predictors of VRIs. The period was the strongest predictor of VRI (p = 0.0075). After adjustment for age and age and sex interaction, the survival rate was 53% at the end of Period 2 and 91% at the end of Period 3. Conclusions. Rates of VRIs have decreased with the addition of ac-EVDs to the routine use of prolonged systemic antibiotics at the authors' institution.
机译：目的。作者评估了抗生素涂覆的患者的外腔（AC-EVDS）作为标准护理后患抗性相关感染（VRI）的肠胃术相关感染（VRI）的速率。方法。回顾性图表审查是对入院的成年患者进行了患者，该患者患有Newyork-Presbyterian医院神经系统重症监护病房，在2007年2月和2009年11月在2009年12月之间被置于EVD，不包括因主要设备的ANINFETIENS收到EVDS的个人。根据使用中的EVD类型定义三个时间段：期间1，常规EVDS;期间2，AC-EVDS或常规EVDS;和第3期，AC-EVDS。在3个时期发生的明确/可能的VRI是通过使用COX比例危害模型作为VRI的决定因素评估的。给出了延长的全身抗生素在每个机构政策的3个时期中的每一个中的EVD放置期间。结果。评估141个个人的数据;平均患者年龄为53.8±17.2岁，54％是女性。有2个确定和19个可能的VRI。明确/可能的VRI（每1000人 - 导管天）的发生率分别在1至3周期1至3（24.5,16.2和4.4周期，分别为1,2和3分别; P <0.0001）。 VRI的患者比雄性更容易是女性（23.7％Vs 3.1％，P <0.003），并且持续时间更长，尽管3个时期没有显着差异（7.9±6.7 [期1]，8.1±7.1 [期间2]，8.6±5.8 [期3]平均天; P = 0.87，ANOVA）。逐步模型中的效果改性分析显示，期间，年龄和年龄和女性相互作用是VRI的重要预测因子。该期间是VRI最强的预测因子（P = 0.0075）。调整年龄和年龄和性别相互作用后，期末率为53％，在第3期结束时为53％，结束3.结论。随着AC-EVDS在作者机构的常规使用常规使用常规使用AC-EVDS，VRI的速率降低。

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